Executive functions in trauma-exposed youth: a meta-analysis
Rosanne Op den Kelder1,2, Alithe L Van den Akker3, Hilde M Geurts4,5
1Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.
European Journal of Psychotraumatology
|January 25, 2021
Summary
Trauma exposure is linked to lower executive functions in youth, impacting working memory, inhibition, and cognitive flexibility. Clinical practice should address these executive function deficits in trauma-affected children and adolescents.
Area of Science:
- Neuroscience
- Developmental Psychology
- Clinical Psychology
Background:
- Previous research suggests a link between trauma exposure and reduced executive functioning in youth.
- Executive functions, including working memory, inhibition, and cognitive flexibility, follow distinct developmental paths.
- This study specifically examines these three core executive functions in relation to trauma.
Purpose of the Study:
- To conduct a multi-level meta-analysis on the association between trauma exposure and executive functions in youth.
- To investigate potential moderators of this association, including trauma characteristics, study demographics, and measurement quality.
- To provide evidence-based recommendations for clinical practice regarding executive function deficits in trauma-exposed youth.
Main Methods:
- A multi-level meta-analysis was performed on 55 studies with 322 effect sizes.
- Data were sourced from MEDLINE, Embase, and PsycINFO, published between 2001 and 2017.
- Participants (N=8070) ranged from 2 to 25 years old, with analyses examining trauma-specific, study, and measurement moderators.
Main Results:
- Small to medium negative effect sizes were found for working memory (d = -0.49), inhibition (d = -0.46), and cognitive flexibility (d = -0.44).
- Measurement quality moderated the working memory association, with stronger effects in lower-quality studies.
- Violence-exposed/abused and foster care/adopted youth exhibited more inhibition problems; foster care/adopted youth also showed more cognitive flexibility deficits compared to single trauma-exposed youth.
Conclusions:
- Trauma-exposed youth demonstrate significantly lower levels of executive functions, specifically working memory, inhibition, and cognitive flexibility.
- Clinical assessment and treatment guidelines should integrate the evaluation and management of executive function impairments in this population.
- Understanding the nuances of trauma type and measurement quality is crucial for accurately assessing executive function deficits.
Keywords:
Psychotraumacognitive flexibilityexecutive functionsinhibitionmeta-analysispost-traumatic stress disorderworking memoryyouth• Abusedviolence-exposedadopted and foster care youth have lower levels of inhibition.• Adopted and foster care youth have lower levels of cognitive flexibility.• Low-quality measurement studies show lower levels of working memory in trauma-exposed youth.• Executive functioning should be a focus in treatment of trauma-exposed youth.
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